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Family Medicine End of Rotation ™ Exam Blueprint & Topic List

Last updated: August 20, 2026

Summarytoggle arrow icon

The Family Medicine End of Rotation™ (EOR) exam is one of the PA Education Association’s objective, standardized evaluations and is intended to serve as one measure of the medical knowledge PA students gain during their supervised clinical practice experience. This article outlines the updated PAEA Family Medicine EOR Exam Blueprint, including its content and task areas, and presents the Exam Topic List. The specifications presented here reflect the updated Family Medicine Blueprint and Topic List published by PAEA as of July 2026. Updated Family Medicine exam versions based on these specifications were published July 2026; legacy Family Medicine examinations remain available through July 2027, so students should confirm which version their program is administering. Questions on an examination represent only a sample of the content that may be assessed and may not reflect every topic identified in the Topic List. Exam candidates and clinical coordinators are encouraged to review the original Blueprint, Topic List, and Core Tasks and Objectives through PAEA’s End of Rotation™ Blueprints and Topic Lists resource page at https://paeaonline.org/assessment/end-of-rotation/blueprints-and-topic-lists. [1]

AMBOSS is an independent entity with no affiliation to or endorsement by the PA Education Association (PAEA) or the PAEA End of Rotation™ examinations. The PAEA-derived portions of this article are based on the PAEA Family Medicine End of Rotation™ Exam Blueprint, Topic List, and Core Tasks and Objectives, which are created and owned by PAEA®. The family medicine-specific "Knowledge of" and "Skill in" descriptions, general study guidance, and organization of certain Professional Practice concepts were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source. AMBOSS does not claim ownership of material originating from PAEA. This article is provided at no cost to the public as an informational resource for PA students, educators, clinicians, and other healthcare professionals. It is not an official PAEA publication and does not contain actual PAEA examination questions. Use or reproduction of PAEA materials is subject to PAEA’s applicable terms and any required permissions. [2]

Overviewtoggle arrow icon

Content Categories

Content Category
 Percentage
Cardiovascular 14%
Eyes, Ears, Nose, Oral Cavity, and Throat (EENOT) 10%
Gastrointestinal 10%
Pulmonary 10%
Dermatologic 7%
Endocrine 7%
Psychiatric/Behavioral Health 7%
Rheumatologic/Musculoskeletal 7%
Gynecologic/Reproductive Health 6%
Neurologic 6%
Renal/Genitourinary 6%
Hematologic 5%
Infectious Diseases 5%

Task Categories

Task Category
 Percentage
History & Physical 16%
Diagnostic Studies 14%
Diagnosis 20%
Health Maintenance 12%
Clinical Intervention 8%
Clinical Therapeutics 18%
Scientific Concepts 6%
Professional Practice 6%

Each End of Rotation™ exam contains 120 multiple-choice questions, including 100 scored questions and 20 unscored pretest questions. The Blueprint percentages apply to the 100 scored questions. The updated Family Medicine Blueprint is organized by both content area and task area, and Professional Practice is one of its eight task areas.

General study approach

  • Use the Blueprint percentages to set relative study priorities rather than to exclude lower-percentage categories.
    • Cardiovascular, eyes, ears, nose, oral cavity, and throat, gastrointestinal, and pulmonary together account for 44% of the scored questions; however, every listed category remains testable.
    • Diagnosis, Clinical Therapeutics, and Health Maintenance together account for 50% of the scored questions, emphasizing the need to integrate diagnostic reasoning, pharmacologic management, preventive care, and longitudinal follow-up.
  • Family Medicine End of Rotation™ questions cover the full lifespan and may be set in ambulatory, urgent care, and long-term care settings. Preparation should therefore include pediatric, adolescent, adult, pregnant, geriatric, immunocompromised, and medically complex patients.
  • End of Rotation™ questions use a one-best-answer clinical-vignette format intended to assess higher-order thinking. Study each condition through its risk factors, typical and atypical presentations, key distinguishing findings, appropriate diagnostic evaluation, first-line treatment, preventive needs, monitoring, referral indications, and follow-up.

Medical Content Categoriestoggle arrow icon

Content Categories

Content Category
 Percentage
Cardiovascular 14%
Eyes, Ears, Nose, Oral Cavity, and Throat (EENOT) 10%
Gastrointestinal 10%
Pulmonary 10%
Dermatologic 7%
Endocrine 7%
Psychiatric/Behavioral Health 7%
Rheumatologic/Musculoskeletal 7%
Gynecologic/Reproductive Health 6%
Neurologic 6%
Renal/Genitourinary 6%
Hematologic 5%
Infectious Diseases 5%

Cardiovascular (14%)toggle arrow icon

Arrhythmias/Conduction disorders

  • Atrial
  • Heart blocks
  • Junctional
  • Premature beats
  • Ventricular

Cardiomyopathy

Congenital heart disease

Coronary artery disease

Heart failure

Hypertensive disorders

Hypotension

Lipid disorders

Traumatic, infectious, and inflammatory disorders

Valvular disorders

Vascular disorders

Eyes, Ears, Nose, Oral Cavity, and Throat (EENOT) (10%)toggle arrow icon

Ear disorders

Eye disorders

Vision abnormalities

Neoplasms

  • Benign
  • Malignant

Nose/Sinus disorders

Oropharyngeal disorders

Gastrointestinal (10%)toggle arrow icon

Biliary tract disorders

Esophageal disorders

Food allergies and food sensitivities

Foodborne illness

Gastric disorders

Gastrointestinal bleeding

Hepatic disorders

Ingestion of harmful substances

Intestinal/Colorectal disorders

Neoplasms

  • Benign
  • Malignant

Nutrition

Pancreatitis

Toxidromes

  • Substances

Dermatologic (7%)toggle arrow icon

Acne vulgaris

Allergic reactions

Diseases of hair, nails, or skin

Infectious disorders

Neoplasms

Skin infestations

Skin lesions

Vector-borne illness

Wounds

Psychiatric/Behavioral Health (7%)toggle arrow icon

Task Categoriestoggle arrow icon

Task Categories

Task Category
 Percentage
History & Physical 16%
Diagnostic Studies 14%
Diagnosis 20%
Health Maintenance 12%
Clinical Intervention 8%
Clinical Therapeutics 18%
Scientific Concepts 6%
Professional Practice 6%

*AMBOSS editorial study guidance: The following family medicine-specific "Knowledge of" and "Skill in" descriptions were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source.

History & Physical (16%)toggle arrow icon

  • Knowledge of:
    • Components and techniques of comprehensive, focused, and problem-based histories and physical examinations across the lifespan
    • Pertinent medical, surgical, family, medication, allergy, obstetric, gynecologic, psychiatric, social, occupational, travel, and exposure histories
    • Risk factors, typical presentations, and red-flag findings associated with common acute and chronic conditions encountered in family medicine
    • Developmental, behavioral, educational, and caregiver history appropriate to pediatric and adolescent patients
    • Functional status, fall risk, cognition, sensory impairment, caregiver support, and activities of daily living in older adults
    • Medication reconciliation, including prescription medications, over-the-counter products, supplements, adherence, adverse effects, and interactions
    • Effects of housing, food access, transportation, finances, health literacy, family roles, and other social determinants on health
  • Skill in:
    • Conducting comprehensive and/or problem-based interviews and physical examinations with compassion, cultural humility, and a patient-centered approach
    • Obtaining pertinent information from patients, families, caregivers, medical records, consultants, and other available sources
    • Performing age-appropriate cardiovascular, pulmonary, abdominal, neurologic, musculoskeletal, dermatologic, EENOT, breast, and genitourinary examinations
    • Assessing growth, development, pubertal status, pregnancy possibility, cognition, gait, balance, frailty, and functional status when appropriate
    • Conducting sensitive examinations and assessments respectfully, including breast, pelvic, genital, rectal, abuse, neglect, and interpersonal-violence evaluations
    • Recognizing abnormal vital signs, toxic appearance, altered mental status, respiratory distress, focal neurologic deficits, and other findings that require urgent escalation
    • Integrating history and physical examination findings to distinguish disorders, prioritize the differential diagnosis, and determine the urgency of evaluation

Diagnostic Studies (14%)toggle arrow icon

  • Knowledge of:
  • Skill in:
    • Selecting appropriate initial and subsequent diagnostic, laboratory, and screening studies
    • Collecting blood, urine, respiratory, genital, skin, wound, and other specimens using appropriate technique
    • Reviewing and interpreting common laboratory studies, electrocardiograms, spirometry, imaging, and point-of-care tests in the context of the patient’s history and examination findings
    • Comparing current findings with prior results and monitoring clinically meaningful trends
    • Recognizing results that require emergency evaluation, prompt treatment, referral, surveillance, repeat testing, or additional diagnostic evaluation
    • Determining when testing is unnecessary because the result is unlikely to change management
    • Communicating indications, risks, benefits, uncertainty, incidental findings, and follow-up plans clearly to patients and caregivers
    • Tracking ordered studies and closing the loop on abnormal or incomplete results

Diagnosis (20%)toggle arrow icon

  • Knowledge of:
    • Significance of the history, physical examination, laboratory studies, diagnostic findings, and clinical course as they relate to the differential diagnosis
    • Epidemiology, risk factors, pathophysiology, diagnostic criteria, and typical or atypical presentations of common acute and chronic conditions
    • Age-specific and population-specific differences in disease presentation across pediatric, adolescent, adult, pregnant, immunocompromised, and geriatric patients
    • Red-flag features that distinguish conditions appropriate for outpatient management from those requiring urgent or emergency evaluation
    • Natural history, expected course, recurrence patterns, complications, and end-organ effects of common diseases
    • Effects of multimorbidity, medications, pregnancy, functional status, social determinants, and health disparities on disease presentation
  • Skill in:
    • Formulating an appropriately prioritized differential diagnosis based on the available clinical data
    • Selecting the most likely diagnosis while maintaining consideration of serious alternative diagnoses
    • Distinguishing acute from chronic disease and stable from unstable clinical presentations
    • Recognizing conditions that can be diagnosed clinically without unnecessary testing
    • Identifying concurrent diagnoses, complications, and end-organ effects during comprehensive and continuity visits
    • Revising the differential diagnosis when symptoms persist, treatment fails, or new findings emerge
    • Recognizing when consultation, specialty referral, emergency transfer, hospitalization, or additional diagnostic evaluation is required
    • Managing diagnostic uncertainty through appropriate follow-up, safety-net instructions, and reassessment

Health Maintenance (12%)toggle arrow icon

Clinical Intervention (8%)toggle arrow icon

  • Knowledge of:
  • Skill in:
    • Selecting and prioritizing interventions that are consistent with the working diagnosis, severity, setting, and available resources
    • Obtaining informed consent and explaining expected benefits, risks, alternatives, and postprocedure care
    • Performing or assisting with appropriate office-based procedures using sterile technique and within the PA’s training and assigned role
    • Providing immediate stabilization for urgent or emergent presentations while arranging a higher level of care
    • Selecting and coordinating appropriate nonpharmacologic therapies, consultations, referrals, and rehabilitation services
    • Evaluating patient response, adherence, effectiveness, adverse effects, and complications after an intervention
    • Providing patient and caregiver education, return precautions, and appropriate medical, procedural, or rehabilitation follow-up
    • Recognizing when an intervention exceeds the clinician’s competence or the safety limits of the outpatient setting

Clinical Therapeutics (18%)toggle arrow icon

  • Knowledge of:
    • Indications for use
    • Contraindications and precautions
    • Mechanisms of action
    • Dosing and routes of administration
    • Pharmacokinetics and pharmacodynamics
    • First-line and alternative pharmacologic treatments for common acute and chronic conditions encountered in family medicine
    • Evidence-based treatment goals and medication-monitoring requirements for common chronic diseases
    • Principles of antimicrobial stewardship and appropriate treatment of bacterial, viral, fungal, and parasitic infections
    • Age-, weight-, renal-, hepatic-, pregnancy-, lactation-, and geriatric-specific medication considerations
    • Drug interactions, polypharmacy, prescribing cascades, adverse effects, allergic reactions, withdrawal syndromes, and medication toxicity
    • Indications for medication initiation, titration, substitution, tapering, discontinuation, and deprescribing
    • Effects of adherence barriers, formulary limitations, cost, regimen complexity, and access on pharmacotherapy
  • Skill in:
    • Developing individualized pharmacologic treatment plans that incorporate comorbidities, patient preferences, reproductive status, function, cost, and access
    • Selecting appropriate first-line medications and modifying regimens based on response, adverse effects, and changing goals of care
    • Writing complete and accurate prescriptions with the appropriate dose, route, frequency, duration, quantity, and instructions
    • Calculating weight-based doses and adjusting medications for renal or hepatic impairment
    • Reconciling medications and identifying duplication, interactions, nonadherence, potentially inappropriate medications, and prescribing cascades
    • Monitoring therapeutic response through symptoms, examination findings, laboratory studies, home measurements, and validated assessment tools
    • Recognizing treatment failure, adverse reactions, drug interactions, and medication toxicity and taking appropriate action
    • Counseling patients and caregivers regarding medication purpose, administration, expected benefits, adverse effects, precautions, monitoring, and adherence
    • Creating longitudinal follow-up plans for chronic disease management and pharmacotherapy monitoring

Scientific Concepts (6%)toggle arrow icon

  • Knowledge of:
  • Skill in:
    • Applying anatomy, physiology, and pathophysiology to diagnosis and management
    • Relating underlying mechanisms to symptoms, examination findings, diagnostic results, complications, and treatment response
    • Using epidemiologic information and pretest probability to guide diagnostic reasoning
    • Applying microbiologic, immunologic, genetic, and pharmacologic principles to patient care
    • Interpreting basic clinical research findings and determining whether they apply to an individual patient
    • Comparing the benefits, harms, and certainty of evidence for competing screening, diagnostic, or therapeutic strategies
    • Incorporating evidence-based medicine, clinical judgment, patient preferences, and multimorbidity into decision-making
    • Evaluating emerging evidence and determining when it should alter preventive, diagnostic, or treatment practices

Professional Practice (6%)toggle arrow icon

Legal/medical ethics

  • Knowledge of:
  • Skill in:
    • Obtaining informed consent and assessing whether a patient can understand, appreciate, reason about, and communicate a health care decision
    • Supporting informed, voluntary, and patient-centered decisions through shared decision-making
    • Maintaining confidentiality while recognizing situations that require disclosure or mandated reporting
    • Communicating with legally authorized representatives when a patient lacks decision-making capacity
    • Recognizing and escalating complex ethical or legal concerns to the supervising physician, ethics service, risk management, legal counsel, or other appropriate resource

Medical informatics

  • Knowledge of:
    • Accurate and complete documentation of histories, examinations, assessments, procedures, counseling, follow-up, and continuity plans
    • Documentation and coding requirements related to reimbursement, quality reporting, preventive care, chronic disease management, and administrative purposes
    • Electronic health records, clinical decision-support systems, patient portals, telemedicine, electronic prescribing, prescription-monitoring programs, and evidence-based resources
    • Risks associated with copied documentation, incomplete medication reconciliation, alert fatigue, privacy breaches, and failure to follow abnormal results
  • Skill in:
    • Documenting clinical reasoning, uncertainty, counseling, shared decisions, follow-up, and return precautions accurately and promptly
    • Using health information systems to review prior records, reconcile medications, identify preventive needs, and coordinate longitudinal care
    • Tracking diagnostic studies, referrals, abnormal results, and overdue follow-up until appropriate action is completed
    • Protecting patient information when using electronic records, portals, mobile devices, telemedicine, and other communication systems

Patient care and communication (individual patients)

  • Knowledge of:
    • Affordable, effective, and patient-specific primary care across the lifespan
    • Communication and care preferences of diverse patients, families, and caregivers
    • Effects of health literacy, language, disability, culture, family structure, finances, housing, transportation, food access, and social support on health decisions and outcomes
    • Developmentally appropriate, trauma-informed, and culturally responsive communication principles
    • Communication strategies for diagnostic uncertainty, chronic illness, serious diagnoses, poor prognosis, behavior change, and disagreement
  • Skill in:
    • Establishing longitudinal therapeutic relationships with empathy, professionalism, cultural humility, and respect
    • Using qualified interpreters and accessible communication methods when appropriate
    • Explaining diagnoses, uncertainty, treatment options, risks, benefits, preventive recommendations, and follow-up plans in understandable language
    • Confirming comprehension through teach-back and adapting education to health literacy, cognitive, sensory, and developmental needs
    • Engaging patients, families, and caregivers in shared decision-making while respecting patient preferences and autonomy
    • Communicating difficult information and maintaining therapeutic relationships during disagreement, distress, or changes in goals of care
    • Identifying barriers to adherence and coordinating realistic resources and follow-up plans

PA role in professional practice

  • Knowledge of:
    • Professional and clinical limitations, scope of practice, credentialing, privileging, supervision, and collaboration requirements
    • Responsibilities of the PA in preventive care, acute care, chronic disease management, office procedures, care coordination, and transitions of care
    • Roles and responsibilities of physicians, nurses, pharmacists, behavioral health clinicians, therapists, social workers, specialists, and community health professionals
    • Professional boundaries, conflicts of interest, clinician impairment, ethical conduct, and effects of implicit bias on assessment and treatment
  • Skill in:
    • Recognizing personal limitations and seeking supervision, consultation, referral, or transfer of care appropriately
    • Communicating effectively during referrals, handoffs, consultations, and interprofessional discussions
    • Coordinating care across primary care, specialty care, emergency care, hospital care, rehabilitation, long-term care, and community services
    • Maintaining professional behavior, accountability, reliability, and appropriate boundaries with patients, families, colleagues, and learners

Professional development

  • Knowledge of:
    • Continuing medical education resources relevant to preventive care, acute illness, chronic disease, behavioral health, and care across the lifespan
    • Evidence-based guidelines, quality standards, performance measures, and evolving primary-care practices
    • Principles of lifelong learning, self-assessment, feedback, clinician well-being, and maintenance of professional competence
  • Skill in:
    • Critically evaluating medical literature and applying evidence-based recommendations appropriately
    • Identifying and interpreting information from reliable medical and primary-care sources
    • Recognizing personal knowledge or skill gaps and pursuing education, feedback, supervision, or additional training
    • Using clinical outcomes, reflection, morbidity review, and quality-improvement activities to improve future performance

Public health (population/society)

  • Knowledge of:
  • Skill in:
    • Recognizing reportable diseases and following applicable public-health and mandated-reporting requirements
    • Identifying emerging infections, exposure clusters, and other population-level health concerns
    • Counseling patients regarding prevention, risk reduction, immunization, and healthy behaviors
    • Connecting patients and families with preventive, behavioral, social, and community-based services
    • Recognizing health disparities and incorporating population-level risks and barriers into individual care plans

Risk management

  • Knowledge of:
  • Skill in:
    • Using medication reconciliation, allergy review, interaction screening, patient identification, and procedural safety checks to prevent harm
    • Providing explicit return precautions and safety-net instructions when managing uncertain or evolving conditions
    • Tracking referrals, diagnostic studies, abnormal results, and overdue follow-up to prevent loss to care
    • Recognizing, documenting, disclosing, reporting, and responding appropriately to adverse events and near misses
    • Providing safe handoffs and transitions that communicate active problems, completed and pending studies, treatments, follow-up needs, and contingency plans
    • Escalating concerns when patient safety, clinician impairment, staffing, equipment function, or standards of care are compromised

Disclaimertoggle arrow icon

AMBOSS is an independent entity with no affiliation to or endorsement by the PA Education Association (PAEA) or the PAEA End of Rotation™ examinations. The PAEA-derived portions of this article are based on the publicly available PAEA Family Medicine End of Rotation™ Exam Blueprint, Topic List, and Core Tasks and Objectives, which are solely created and owned by PAEA®. The family medicine-specific "Knowledge of" and "Skill in" descriptions, general study guidance, and organization of certain Professional Practice concepts were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source. AMBOSS does not claim ownership of material originating from PAEA. This article is provided at no cost to the public as an informational resource for PA students, educators, clinicians, and other healthcare professionals. It is not an official PAEA publication and does not contain actual PAEA examination questions. Questions on an examination represent only a sample of the content that may be assessed, and the Topic List is not a comprehensive list of all possible examination topics. Use or reproduction of PAEA materials is subject to PAEA’s applicable terms and any required permissions. [2]

Referencestoggle arrow icon

  1. . PAEA EOR blueprints & topic list 2026. . 2026.
  2. . PAEA Website and Services Terms of Use. . .

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